Document Detail


Differential response of speed, amplitude, and rhythm to dopaminergic medications in Parkinson's disease.
MedLine Citation:
PMID:  21953789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although movement impairment in Parkinson's disease includes slowness (bradykinesia), decreased amplitude (hypokinesia), and dysrhythmia, clinicians are instructed to rate them in a combined 0-4 severity scale using the Unified Parkinson's Disease Rating Scale motor subscale. The objective was to evaluate whether bradykinesia, hypokinesia, and dysrhythmia are associated with differential motor impairment and response to dopaminergic medications in patients with Parkinson's disease. Eighty five Parkinson's disease patients performed finger-tapping (item 23), hand-grasping (item 24), and pronation-supination (item 25) tasks OFF and ON medication while wearing motion sensors on the most affected hand. Speed, amplitude, and rhythm were rated using the Modified Bradykinesia Rating Scale. Quantitative variables representing speed (root mean square angular velocity), amplitude (excursion angle), and rhythm (coefficient of variation) were extracted from kinematic data. Fatigue was measured as decrements in speed and amplitude during the last 5 seconds compared with the first 5 seconds of movement. Amplitude impairments were worse and more prevalent than speed or rhythm impairments across all tasks (P < .001); however, in the ON state, speed scores improved exclusively by clinical (P < 10(-6) ) and predominantly by quantitative (P < .05) measures. Motor scores from OFF to ON improved in subjects who were strictly bradykinetic (P < .01) and both bradykinetic and hypokinetic (P < 10(-6) ), but not in those strictly hypokinetic. Fatigue in speed and amplitude was not improved by medication. Hypokinesia is more prevalent than bradykinesia, but dopaminergic medications predominantly improve the latter. Parkinson's disease patients may show different degrees of impairment in these movement components, which deserve separate measurement in research studies. © 2011 Movement Disorder Society.
Authors:
Alberto J Espay; Joe P Giuffrida; Robert Chen; Megan Payne; Filomena Mazzella; Emily Dunn; Jennifer E Vaughan; Andrew P Duker; Alok Sahay; Sang Jin Kim; Fredy J Revilla; Dustin A Heldman
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-09-23
Journal Detail:
Title:  Movement disorders : official journal of the Movement Disorder Society     Volume:  26     ISSN:  1531-8257     ISO Abbreviation:  Mov. Disord.     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-15     Completed Date:  2012-02-28     Revised Date:  2013-06-27    
Medline Journal Info:
Nlm Unique ID:  8610688     Medline TA:  Mov Disord     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2504-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Movement Disorder Society.
Affiliation:
UC Neuroscience Institute, Department of Neurology, Gardner Center for Parkinson's disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio 45267-0525, USA. alberto.espay@uc.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Dopamine Agents / administration & dosage*
Drug Monitoring / statistics & numerical data
Humans
Hypokinesia / drug therapy,  physiopathology
Levodopa / administration & dosage*
Middle Aged
Movement / drug effects*
Neurologic Examination / statistics & numerical data*
Neurology / statistics & numerical data
Observer Variation
Parkinson Disease / drug therapy*,  physiopathology
Videotape Recording
Grant Support
ID/Acronym/Agency:
7R43NS065554-03/NS/NINDS NIH HHS; K23 MH092735-01A1/MH/NIMH NIH HHS; R43 NS065554/NS/NINDS NIH HHS
Chemical
Reg. No./Substance:
0/Dopamine Agents; 0/Levodopa
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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